Provider Demographics
NPI:1992069736
Name:PRASAD, ANJU SUSAN (MD)
Entity type:Individual
Prefix:MRS
First Name:ANJU
Middle Name:SUSAN
Last Name:PRASAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:121 CAHILL RD STE 201
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-1911
Practice Address - Country:US
Practice Address - Phone:417-348-8990
Practice Address - Fax:417-348-8090
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2017014155207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism